A tracheotomy is an operation wherein a physician makes an incision into the neck and trachea of a patient. A tracheostomy tube, through which the patient will breath, is then inserted by the physician into the trachea through the incision. Tracheostomy tubes are required in cases where breathing through the nose or mouth has become impossible. While man tracheostomies are of a temporary nature, others are permanent.
To keep the tracheostomy tube from dislodging and/or falling out, for example, when the patient forcefully coughs, the tube is typically secured by cloth straps or ties attached to or through slotted flanges extending from the periphery of the tracheostomy tube. The straps or ties are then fastened together at the back of the neck of the wearer. A 4" by 4" square gauze bandage cut into an "upside-down pants" configuration is placed at the neck region about the tracheostomy tube which protrudes from the tracheal stoma. At this location, the gauze dressing is used to collect mucous and tracheal secretions.
While patients receive tracheostomies for a number of reasons, the benefits are not without risks. The number one risk being the risk of infection. Even a minor infection can increase a patient's hospital stay 5 to 7 days. Serious infection can lead to other complications and even death.
The use of cloth straps or ties to secure the tracheostomy tube to the patient, to prevent expulsion of the tube, and a gauze dressing at the tracheal site, to absorb tracheal secretions and debris around the stomal site, poses a number of problems.
The ties are disadvantageous in that they not only become soiled, but also become wet with tracheal secretions as well as with perspiration. The ties are uncomfortable to many patients and, especially when wet, can cause skin irritation and breakdown around the patient's neck. When wetness is coupled with irritation, the opportunity for infection is present. In addition, the ties are not aesthetically pleasing. This cosmetic drawback is particularly important when the tracheostomy is of a permanent nature and the patient is forced to return home and enter the community with the tracheostomy tub intact.
The gauze that is placed around the tracheal stoma to absorb secretions during the healing process is problematic in that skin irritation and/or infection can result from the secretion-soaked gauze. Not only does the secretion-soaked gauze act to irritate the skin and hinder healing of the stomal area, but the moist, warm environment is an excellent medium for bacteria to grow and infect the patient through the stomal opening. Such an infection may lead to serious complications, including pneumonia. If the patient does become infected, there is a risk that the infection could spread to other patients as well as to hospital personnel. In order to help reduce or prevent irritation and infections, the gauze must be frequently changed and the tracheal stoma site cleansed. Moreover, the gauze, like the ties, has a poor cosmetic appearance.
Traditional tracheostomy dressings employing the aforementioned ties and gauze dressing are additionally disadvantageous in terms of cost effectiveness. In order to prevent the incidence of infection and irritation, the stomal area needs to be cleansed and the ties and gauze dressing changed every 8 hours, and as often as every 2 hours during the twenty-four hours immediately following surgery. Not only are frequent changes required, but such changes require the services of two health care professionals. One nurse must hold the tracheostomy tube in place while another nurse attends to cleansing and replacing the soiled ties and gauze dressing.
Alternative methods to dress a patient who has had a tracheotomy have been sought. Experiments have been conducted which use an occlusive adhesive-backed dressing. An occlusive dressing is one that is impermeable to the passage of air and moisture. The back of the occlusive dressing contains a skin sensitive adhesive which adheres to the throat around the tracheal stoma. It has been found that the use of such a dressing promotes healing of the tracheal area. While occlusive dressings have been used to surround the tracheal opening and have been shown to promote healing, they have all been used in conjunction with conventional ties. Further, the occlusive dressings of the prior art completely surround the tracheal opening and include no means of collecting tracheal secretions. As such, the occlusive dressing must be peeled off daily and replaced. No method has been developed for securing the tracheostomy tube and collecting the tracheal secretions which sufficiently overcomes the prior art method.